患者手术后应用注药型气管导管疗效的评估

Application and efficacy of endotracheal tube of drug injection for postoperative patients

目的评估注药型气管导管在手术后患者中应用的疗效。方法以2015年1月至2016年8月在河南省人民医院手术治疗后行机械通气的重症医学科患者60例为研究对象，数字表法将其随机分为观察组（30例）和对照组（30例）。观察组患者采用注药型气管导管向气管内注射2%利多卡因进行表面麻醉。对照组患者用生理盐水替代利多卡因。观察和比较两组患者机械通气12 h内对气管导管的耐受能力、心血管系统的不良反应、镇静药物的使用情况。结果观察组患者在术后机械通气12 h内呛咳、高血压和心动过速的发生次数分别为（0.6±0.3）、（0.8±0.3）、（1.3±0.6）次，均明显低于对照组，分别为（5.9±2.1）、（6.0±1.9）、（4.9±1.8）次，差异均有统计学意义（均P〈0.05）。另外，观察组患者机械通气12 h内镇静药物平均使用次数为（0.8±0.3）次，咪唑安定的使用剂量为（1.2±0.3）mg。对照组患者机械通气12 h内镇静药物平均给药次数为（5.1±1.9）次，咪唑安定的使用剂量为（9.9±3.2）mg。观察组患者无论是镇静药物的给药次数，还是药物的使用剂量均明显低于对照组（P〈0.05）。结论采用注药型气管导管进行气道表面麻醉能够提高重症患者对气管导管的耐受性，减少镇静药物的使用量，减少心血管不良事件的发生率。

To evaluate the efficacy of endotracheal tube for drug injection in postoperative ICU patients.MethodsA total of 60 ICU patients who were given mechanical ventilation after surgical treatment were enrolled in this study from January 2015 to August 2016 at our hospital. All the patients were divided into the observation group （30 cases） and the control group （30 cases）. In the observation group, the patients were treated with the endotracheal tube for surface anesthesia by injecting 2% lidocaine into the trachea, and patients in the control group were treated with saline instead of lidocaine. Patients′ tolerance to endotracheal tube, cardiovascular system adverse reactions, the frequency and dosage of sedative and analgesic drug within 12 h mechanical ventilation post operation were analyzed and compared between the two groups.ResultsThe occurrence rate of cough, hypertension and tachycardia in the observation group were（0.6±0.3）, （0.8±0.3）and（1.3±0.6）, respectively, which were significantly lower than the control group （5.9±2.1）, （6.0±1.9）and（4.9±1.8）, the differences were statistically significant （P〈0.05）. In addition, the frequency of sedative drug was （0.8±0.3）, with a dosage of midazolam（1.2±0.3）mg. While in the control group, the frequency of sedative drugs was （5.1±1.9）, with a dosage of midazolam （9.9±3.2） mg. The frequency and dosage of sedative drug administration in the observation group were significantly lower than those in the control group, the difference was significant difference （P〈0.05）.ConclusionsThe use of endotracheal tube for drug injection can improve the tolerance of ICU patients to endotracheal tube, reduce the dosage of sedative drugs, and reduce the adverse cardiovascular reactions.